NPIMap

Organization Active NPI

A-1 Customized Companion Services LLC.

  • Community/Behavioral Health Agency
  • Gretna, LA
National Provider Identifier
1578892063
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
15292 Issued in LA
Legal business name
A-1 CUSTOMIZED COMPANION SERVICES LLC.
Practice address
2100 Belle Chasse Hwy # C
Gretna, LA 70053-6651
Phone
(504) 913-5452
Fax
(504) 367-6601
NPI assigned
Dec 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Valerie Melancon
Title
Owener
Phone
(504) 913-5452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 15292 LA Primary

Addresses

Primary practice location

2100 Belle Chasse Hwy # C
Gretna, LA 70053-6651

Mailing address

2100 Belle Chasse Hwy # C
Gretna, LA 70053-6651

Other identifiers 1

IdentifierTypeStateIssuer
000123MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
A-1 Customized Companion Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1578892063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 BELLE CHASSE HWY # C",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700536651",
            "fax_number": "504-367-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BELLE CHASSE HWY # C",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700536651",
            "telephone_number": "504-913-5452",
            "fax_number": "504-367-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A-1 CUSTOMIZED COMPANION SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "MELANCON",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OWENER",
        "authorized_official_telephone_number": "504-913-5452",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "15292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000123",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.